21b - Answer: 45-year-old female presents with laceration in right wrist
HISTORY:
This 45-year-old female presents with laceration in right wrist with glass. Evaluate for foreign body.
(QUIZ ANSWER) TENOSYNOVITIS EXISTS IN:
All of the above.
Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.
FINDINGS:
Gel marker is noted along the radial aspect and dorsal aspect of the wrist. Abnormal signal is noted in the region of the extensor carpi radialis longus. Fluid is noted within the ECRB, ECRL and EPL tendon sheaths for which tenosynovitis is favored.
Interstitial tearing involves the ECRL. The ECRL demonstrates a complete tear with a gap of approximately 3.15cm. This is well visualized on coronal PD SPIR as well as coronal FFE. Small foci of hypointensity on the axial datasets in the region of the ECRL may reflect a shred of remaining intact tendon or an accessory slip of tendon; however, the majority of the tendon is lacerated. No foreign body is demonstrated.
Triangular fibrocartilage and its ulnar attachments are intact. Scapholunate ligament and lunotriquetral ligament are intact. Mild arthrosis involves distal scaphoid including regions of small subchondral cysts. Dorsal capsulitis is demonstrated.
The axial datasets do not extend proximally into the forearm at the level of the retracted tendon.
CONCLUSION:
1. Tenosynovitis involves the ECRB, ECRL and EPL tendon sheaths. The ECRL is lacerated with a gap of approximately 3.15cm. The gap extends from the distal radial diametaphysis to the level of the radial styloid. Linear region of signal in this region may reflect a remaining shred of tendon or a variant slip of tendon.
2. No foreign body is demonstrated.
Case Challenge: Wrist MRI Cases
Case Challenge
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Content reviewed: September 28, 2021